A female cruise ship passenger in her thirties presented to the ship’s doctor with a week-long history of general malaise, flank pain and fever. A urinalysis test was positive for an infection and a course of intravenous antibiotics was commenced to treat pyelonephritis. However, after persistent fever, thrombocytosis, worsening inflammatory blood markers, and a severe anaemia without active bleeding, on-board management was no longer an option.
She was referred to a small island hospital, but in view of her condition versus their resources, her past medical history of chronic anaemia with a suspected family history of haematological disorders, and a haemoglobin of 5.8 g/dL, less than half a normal level for a female of her age, she was declined admission.
Our strategy for case management
Medical Assessment
After being activated to assist, the MedResQ medical team evaluated the medical data and laboratory test results with its in-house critical care doctor and determined that an evacuation by air ambulance to the nearest place of medical safety was necessary. Up until transfer from the ship, the MedResQ medical team kept in close contact with the ship’s doctor and were able to monitor the condition of the patient in real-time.
After a review of the most appropriate hopsitals within our network, the MedResQ medical team liaised with a level-3 trauma centre in Grand Cayman to make the necessary admission arrangements.
Logistical Coordination
The MedResQ medical team contacted its network of air ambulance operators to complete the urgent mission and were able to secure a flight to take place on the same day that the ship arrived into port, thereby closing the time gap for the patient to receive the much-required definitive treatment.
Through our broad experience of complex logistical and medical transfers globally, the MedResQ medical and operations teams provided clear and detailed planning and coordination for all parties, including the ship’s doctor, the patient, the ground and air ambulance teams, and the receiving hospital, whilst ensuring that the client was updated at all points.
Timeliness to definitive healthcare
Through our rapid evaluation of the medical case, and by activating trusted partners within our global network, MedResQ was able to transfer the patient from ship to hospital in under 24 hours.
The patient underwent comprehensive assessments by a nephrologist, haematologist, and radiologist. Following comprehensive assessment, imaging, and tests, she was confirmed to have bilateral severe pyelonephritis, a renal abscess, a liver abscess, and underlying severe iron deficient nutritional anaemia. After a 2-week admission that included multiple blood and iron transfusions and intravenous antibiotic therapy, the patient was sufficiently stable for discharge.
Upon discharge, her haemoglobin was stable and rising, her overall haemodynamic and clinical condition was much improved, and her intravenous treatment had been discontinued. MedResQ coordinated her repatriation to her home country and made the necessary arrangements for a medical assessment upon her return.
Evaluation and Learning Points
Speed
Through our expertise, experience, and with access to a robust partner-network, MedResQ was able to activate an evacuation in the shortest timeframe possible, ensuring the quickest assessment and treatment in a place of medical safety.
Cost
By having close relationships with our network partners, not only can we ensure the most competitive pricing for our clients, but we can also assure the greatest transparency of costs in the delivery of premium medical services.
Health
MedResQ was able to draw on its vast experience of managing challenging international health cases, and with the knowledge and passion of our medical team and specialist advisers, to ensure that the patient was referred to a suitable hospital which could manage her complex and serious health issues.
Holistic Care
MedResQ’s patient focussed case management approach ensured continuity and support for the patient during all aspects of her initial assessment, transfer, and hospital stay. She was provided with telephone and email support during the admission, after discharge, and during all aspects of repatriation planning.
